Dissociation is the ability to cut off from what is happening around you or to you. In its simplest form it is daydreaming. It is a skill all children have and which children with autism tend to overdevelop in managing a world they find overwhelming for a whole range of reasons. Dissociation, Derealisation (the feeling nothing is ‘real’ or that everything feels like a dream), and Depersonalisation (cutting off from emotions, detaching, inability to take experiences personally), are experiences most of us have had. Dissociative disorders are where these create problems with functioning and coping in every day life. Some people will have greater TENDENCY toward developing dissociative disorders and if they then experience significant trauma may be more at risk of Post Traumatic Stress Disorder (PTSD). If they are continually entrapped with such experiences from infancy or very early childhood they may be at risk of more severe dissociative disorders such as Dissociative Disorder Not Otherwise Specified (DDNos) or Dissociative Identity Disorder (DID).

In 2010 I was diagnosed with the dissociative disorder, DID. I have since connected with a number of adults both on and off the autism spectrum who are also diagnosed with DID and used my skills as an autism consultant to begin to navigate the complexities of dissociative disorders. I did some consulting work associated with DID, primarily working with therapists as they came to grips with the DID systems of their clients.

DISSOCIATION AND AUTISM
The higher rate of Schizotypal and Avoidant Personality Disorders among the autistic population who are already known to commonly over-employ dissociation. With anxiety disorders in autistic children thought to run as high as up to 85% co-morbidity, it may be worth exploring the spectrum of dissociative disorders an autistic context.

NEUROIMAGINGNeuroimaging and other neurological testing has shown significant differences in of those who have suffered PTSD associated with severe early trauma as well as those diagnosed with DID.

BETTER DIFFERENTIATION
Recent advances in awareness of DID now allows diagnosing psychiatrists to more easily distinguish DID as a dissociative disorder from BPD, Schizophrenia, Bipolar, (and when it occurs with any of these as co-morbids). With altered criteria for the diagnosis of DID, it can also now be more easily distinguished from hysteria, factitious disorder, or malingering which probably once underpinned the over-diagnosis and criticism of what was once MPD. Nevertheless, controversy surrounding MPD as a valid medical diagnosis continues to haunt DID.

DSM V
This redefining of DID as a dissociative disorder differentiated it from MPD which had been seen as a stand alone personality disorder. There are proposals to include DID in the DSMV as part of the spectrum of dissociative disorders under the section on stress and trauma. Within the DSMIV the following are listed as Dissociative Disorders:

Carmel Anne Jones
Hm, was easier to relate to when they called it MPD (multiple personalities; becomes too confusing otherwise)

Donna Williams
Well, MPD presumed it was a PERSONALITY disorder, and it’s actually not because a PD is where a personality TRAIT has become so extreme that trait is at disorder proportions… like Antisocial, Sadistic, Narcissistic etc personality disorders…. Also, we all have personalities made up of different collections of personality traits, as do alters… do there’s nothing disordered about THAT…. and different people and environments naturally bring out our different personality traits, just like in DID, except that in DID each alter has its OWN set of perceptions, history etc… so again, MPD was misleading… and MPD said nothing of dissociation, which was the main ingredient in SPLITTING, which is purely DISSOCIATIVE… so MPD failed to capture the reality. Sure, it had the word ‘Multiple’ in it, and those with DID experience themselves as Multiple, but the PD part was misleading… sure you could read it as Multiple Personality…. er disorder…. (ie a dissociative disorder involving the experience of multiple personalities/identities) or as Multiple… Personality Disorder (a collection of personality disorders in the one person so each alter is considered relatively personality disordered). And people were taking it the second way. Also MPD was made out to be something bizarre, something so stand alone that nobody without it could possibly imagine it… but as a dissociative disorder, anyone who has experienced dissociation (all humans) could then roughly relate at least to its most primary foundation (of splitting).

yeah I think most people heard MPD as multiple-personality disorder rather than multiple personality-disorder. ironically, I hear DID as dissociative identity-disorder rather than dissociative-identity disorder. but actually either way works when I think about it. both my dissociation and my multiple identities have caused me problems. but originally, they were functional, so I also like the “dissociative identity response” label.

it reminds me of when manic depression was changed to bipolar disorder. both new names are now more clinically “correct,” but the “flavor” of the label is different. maybe because of the connotative meaning, culturally speaking, that had built up around the old ones isn’t there with the new ones. except it’s kinda dumb… I don’t feel stigmatized when I tell people the new label–but that lasts about five seconds, because I have to give them the old label when they look at me with a puzzled expression.

but thanks to your post, I will now be able to explain WHY the label has been changed, if they want to know.

[…] the consultation. So here I was going to the biopsies with my good pal, Denise, who, like me, has Dissociative Identity Disorder (DID). Given her dozen alters and my 13, we brought quite a few people along to the waiting room of […]

[…] Dissociative disorders, which can set in as young as age 2-3 years old or anywhere there after, can go together with Anhedonia if one has become cut off from their Core Self as a result of severe loss, trauma, abuse, neglect. Essentially, if one is living dissociated from their Core Self how can one connect fully with the body, with emotions, feel things personally, especially the more vulnerable emotions and joy, hope, trust are feelings that open us up. For those with dissociative disorders this may also mean feeling the threat of retraumatisation so instead of reconnecting with their Core Self they stay protecting themselves from that, which can, for some people, mean they stay emotionally cut off. […]

My Aspergian son has some sort of disassociation going on with how he categorizes schoolwork in his head. The school has agreed to let him turn in missed assignments for credit. However, even if the work is incredibly easy for him (e.g., science worksheets that involve looking something up on the facing page), because they are overdue, he cannot do it. He can’t explain it other than to say something inside him won’t let him do it. He makes it clear that he is not refusing to do it, he “can’t” do it. I’m not sure what search terms to use to research this through my university library databases. Ideas?

[…] to the degree they are attracted to anything so intriguing as DID. But in fact, there is a spectrum of dissociative disorders which includes things quite common and mundane and with which most people have some […]

[…] Donna Williams’ Blog » Blog Archive » The Spectrum of Dissociative …Mar 25, 2012 … Dissociative fugue is more common in those who have PTSD or recently suffered an extremely traumatic event. Just days before, Sgt. Bales … […]

Donna Williams is an Australian born adult with autism who was assessed as psychotic at the age of 2 in 1965, labelled disturbed in the 1970s and diagnosed as autistic in her 20s in 1991.

She acquired functional speech in late childhood and went on to become a qualified teacher with an honors degree in Sociology and a degree in Linguistics. She is the author of two international bestselling autobiographies and has 10 published books including 4 text books widely used in autism education and two books of poetry and prose.

As a screenwriter, she wrote the screenplay to “Nobody Nowhere”, the first book in her 4 book autobiographical series. That screenplay is currently under option to become a Hollywood film. She is an professional artist, singer-songwriter and published poet as well as a world renowned public speaker on autism now living with her husband in Australia. In her presentations she draws not only on her own experiences but on international experience as a professional autism consultant since 1996.

Donna’s is a speaker in demand around the world due to her unique perspective and ability to share her feelings and experiences on a very personal level. More information about her and her life’s work can be found on her website at http://www.donnawilliams.net .